Saed Hindash/The Star-LedgerGov. Chris Christie is being urged to support the creation of a "health exchange," to conform with new federal health insurance regulations.

TRENTON — With the state Legislature expected to approve a bill Thursday creating a "health exchange" — the cornerstone of the federal health care law that will help people shop for cheaper coverage — a group of family, consumer and senior citizen advocates today challenged Gov. Chris Christie to support the effort.

But Christie, a Republican, has not committed to creating a health exchange, and won't make a decision until the U.S. Supreme Court decides this year whether the Affordable Care Act is constitutional, state Banking and Insurance spokesman Marshall McKnight said. The nation's highest court will hear arguments on the case in two weeks.

Waiting for the Supreme Court's decision, however, is "leaving millions of dollars on the table," said Ray Castro, a senior analyst at New Jersey Policy Perspective, a liberal leaning think tank which participated in the Trenton press conference to call attention to the bill. The Christie administration has delayed applying for larger grants, unlike Pennsylvania which received $30 million and New York that qualified for $40 million.

If by January, the federal government thinks New Jersey is moving too slowly to create its exchange, the Obama administration could step in and create the network, Castro said.

Health exchanges are the marketplaces — available online and by telephone — that small business owners and people will use to compare and buy subsidized insurance coverage from approved carriers, starting in 2014. The Obama administration will provide the state $1 billion in subsidies to make the plans affordable and so that no one pays more than 9 percent of their income to buy a policy, Castro said.

"Shopping for health insurance will be less complicated, as the exchange will present easy to understand choices,'' said Jen Kim of the New Jersey Public Research Interest Group. These bills feature strong consumer assistance and outreach, including the use of navigators to help guide people as they shop."

The bill, (A2171/S1319) calls for a paid executive director and volunteer board of seven appointed by the governor and legislature to oversee the exchange's operations.
About 400,000 people are expected to sign up in 2014 with a total of 800,000 people to be enrolled overall, Castro said.

"I believe the bill has important elements that will give people choice and create competition. There may be changes the administration wants to make but we have to begin to have this conversation,'' said Sen. Joseph Vitale (D-Middlesex), the bill sponsor said in a separate interview. "You could wait but it would compress the time we need to come together to decide what is right for New Jersey."

The state has taken some action towards exploring an exchange, McKnight said, noting that it used a $1.2 million grant to hire consultants, including the Center for Health Care Policy at Rutgers University to hold public forums and gather information about what New Jersey's 1.3 million uninsured people need. The state also got a $7.6 million federal grant to help create the exchange but not yet decided how to use it, he said.

As for seeking additional federal money to create an exchange, McKnight said New Jersey got permission from the U.S. Department of Health and Human Services earlier this month to delay filing its grant applications, as long as the Christie administration can demonstrate they are making some progress.

The Trenton press conference also prompted the New Jersey Business and Industry Association,to renew its opposition to the bill, because it creates a system "too bureaucratic and costly" to be effective, according to an association statement.